Surveillance in Epidemiology (NURS 1113)

Definition and Importance of Surveillance

• Surveillance is the ongoing systematic collection, analysis, and interpretation of health data essential to the planning, implementation, and evaluation of public health practice.
• It provides information to guide public health interventions and is vital for communicating results to public health and medical communities.
• Surveillance is important for detecting outbreaks, providing information about baseline levels of disease, and enabling public health officials to monitor health at the community level.

Types of Surveillance

• Passive surveillance: routine reporting of disease/health events by healthcare providers, with completeness and quality of data dependent on the reporter.
• Active surveillance: health personnel make periodic calls or visits to health facilities to search for/identify new cases.

Establishing a Surveillance System

• Establish objectives: decide which diseases are a priority, frequency, severity, cost, and public interest.
• Develop case definitions: clearly defined in terms of person, place, and time, and categorized by level of certainty (suspect, probable, or confirmed).
• Develop a data collection mechanism: data collection tool, type of specimen required, and information to be included.
• Field test methods: essential before any system is implemented.
• Conduct data analysis: descriptive analysis and hypothesis generation.
• Data interpretation: detect real changes and disseminate information urgently, if necessary.
• Evaluate the system: establish whether objectives were achieved and if changes are needed.

Characteristics of a Good Surveillance System

• Network of motivated people
• Clear, simple reporting mechanism
• Clear objectives
• Efficient communication system
• Case definitions
• Laboratory support
• Appropriate infrastructure
• Good feedback and rapid response (timely)

Characteristics of Surveillance

• Timeliness: to implement effective control measures
• Sensitivity: to identify persons with the disease
• Representation: to provide an accurate picture of the temporal trend of the disease

Surveillance Systems in Jamaica

• Notifiable diseases and health events: Class I, II, and III
• Hospital active surveillance
• Laboratory surveillance
• Hotel surveillance
• Sentinel surveillance system
• Food-borne diseases surveillance
• HIV surveillance
• Surveillance of air and seaports at hospitals, health centers, and private doctor offices
• Post-disaster disease surveillance